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Cancer Apr 2021Although communication quality is associated with patient outcomes, racial disparities in communication exist, disproportionately burdening Black patients. However, most...
BACKGROUND
Although communication quality is associated with patient outcomes, racial disparities in communication exist, disproportionately burdening Black patients. However, most communication research focuses on verbal behaviors in predominantly White patient populations. We used a newly developed and theory-guided network analysis that examines the dynamic interplay and behavioral convergence and divergence between Black patients with cancer and their oncologists during cancer treatment discussions.
METHODS
We applied a nonverbal behavioral coding system to thin slices of video recordings of Black patients and their oncologists discussing treatment. We then estimated 3 networks: 1) a temporal network to determine whether a nonverbal behavior predicts another nonverbal behavior at the next time point in an interaction, and how much each nonverbal behavior influences other nonverbal behaviors and is influenced by other nonverbal behaviors; 2) a contemporaneous network to determine whether a nonverbal behavior co-occurs with other nonverbal behaviors at the same time point in an interaction; and 3) a between-dyads network to examine the covariation between nonverbal behaviors across all dyads.
RESULTS
Black patients (n = 74) and their non-Black physicians (n = 15) showed a mix of convergence and divergence in their nonverbal behaviors at the same points in time, from one time point to the next, and across dyads. Across analyses, convergence was most likely to occur when physicians matched their behaviors to their patients; especially with smiling, gaze, leaning, and laughter behaviors.
CONCLUSION
Our findings reveal patterns of modifiable behaviors that can potentially inform interventions to reduce disparities in clinical communication and, in turn, treatment and mortality disparities.
Topics: Adult; Black or African American; Aged; Aged, 80 and over; Female; Health Communication; Humans; Male; Middle Aged; Neoplasms; Nonverbal Communication; Oncologists; Physician-Patient Relations; Socioeconomic Factors; Time Factors
PubMed: 33290592
DOI: 10.1002/cncr.33352 -
Medical Education Online Dec 2020In this commentary, we argue that the limited experiential exposure of medical students to different cultures makes the instruction devoted to communication skills...
In this commentary, we argue that the limited experiential exposure of medical students to different cultures makes the instruction devoted to communication skills inadequate. The relationship of these dynamics to honesty in clinical encounters is explored. Absent significant experiential exposure to differing group cultures to counter the natural tendency to favor one's own, discrimination prevails. Knowledge or awareness of cultural differences does not necessarily equate to communication proficiency. Critically, interactions based on lived experience offer a deeper knowledge and understanding of culturally meaningful nuances than that imparted through other formats. Medical students' lack of experiential exposure to different cultures results in communication miscues. When the stakes are high, people detect those miscues diminishing trust in the doctor-patient relationship. Greater experiential cultural exposure will enhance the facility and use of culturally specific communication cues. At its core, the requisite transformation will require medical students to adapt to other cultures and greater representation by marginalized and stigmatized populations not only among the studentry but staff and faculty. The time is now to ensure that the physicians we produce can care for all Americans. What cannot be taught must be identified by the selection process. Competence with half the population is a failure for American medicine.
Topics: Clinical Competence; Communication; Curriculum; Deception; Education, Medical; Humans; Nonverbal Communication; Physician-Patient Relations; Students, Medical
PubMed: 32938330
DOI: 10.1080/10872981.2020.1820228 -
Schizophrenia Bulletin Mar 2015Schizophrenia patients are severely impaired in nonverbal communication, including social perception and gesture production. However, the impact of nonverbal social...
Schizophrenia patients are severely impaired in nonverbal communication, including social perception and gesture production. However, the impact of nonverbal social perception on gestural behavior remains unknown, as is the contribution of negative symptoms, working memory, and abnormal motor behavior. Thus, the study tested whether poor nonverbal social perception was related to impaired gesture performance, gestural knowledge, or motor abnormalities. Forty-six patients with schizophrenia (80%), schizophreniform (15%), or schizoaffective disorder (5%) and 44 healthy controls matched for age, gender, and education were included. Participants completed 4 tasks on nonverbal communication including nonverbal social perception, gesture performance, gesture recognition, and tool use. In addition, they underwent comprehensive clinical and motor assessments. Patients presented impaired nonverbal communication in all tasks compared with controls. Furthermore, in contrast to controls, performance in patients was highly correlated between tasks, not explained by supramodal cognitive deficits such as working memory. Schizophrenia patients with impaired gesture performance also demonstrated poor nonverbal social perception, gestural knowledge, and tool use. Importantly, motor/frontal abnormalities negatively mediated the strong association between nonverbal social perception and gesture performance. The factors negative symptoms and antipsychotic dosage were unrelated to the nonverbal tasks. The study confirmed a generalized nonverbal communication deficit in schizophrenia. Specifically, the findings suggested that nonverbal social perception in schizophrenia has a relevant impact on gestural impairment beyond the negative influence of motor/frontal abnormalities.
Topics: Adult; Female; Gestures; Humans; Male; Middle Aged; Nonverbal Communication; Psychotic Disorders; Schizophrenia; Social Perception
PubMed: 25646526
DOI: 10.1093/schbul/sbu222 -
Current Opinion in Neurobiology Jun 2021Integration of social cues to initiate adaptive emotional and behavioral responses is a fundamental aspect of animal and human behavior. In humans, social communication... (Review)
Review
Integration of social cues to initiate adaptive emotional and behavioral responses is a fundamental aspect of animal and human behavior. In humans, social communication includes prominent nonverbal components, such as social touch, gestures and facial expressions. Comparative studies investigating the neural basis of social communication in rodents has historically been centered on olfactory signals and vocalizations, with relatively less focus on non-verbal social cues. Here, we outline two exciting research directions: First, we will review recent observations pointing to a role of social facial expressions in rodents. Second, we will review observations that point to a role of 'non-canonical' rodent body language: body posture signals beyond stereotyped displays in aggressive and sexual behavior. In both sections, we will outline how social neuroscience can build on recent advances in machine learning, robotics and micro-engineering to push these research directions forward towards a holistic systems neurobiology of rodent body language.
Topics: Animals; Communication; Emotions; Facial Expression; Kinesics; Rodentia
PubMed: 33582455
DOI: 10.1016/j.conb.2021.01.008 -
Cancer Apr 2021
Topics: Black or African American; Humans; Nonverbal Communication; Physicians
PubMed: 33290591
DOI: 10.1002/cncr.33353 -
Korean Journal of Medical Education Sep 2018Nonverbal communication (NVC) may be a crucial factor affecting effective communication between patients and medical students during the objective structured clinical...
PURPOSE
Nonverbal communication (NVC) may be a crucial factor affecting effective communication between patients and medical students during the objective structured clinical examination (OSCE), but it has not been intensively studied. We examined NVC and its correlation with patient-physician interaction (PPI) in the OSCE.
METHODS
A total of 68 video recordings of routine check-up OSCEs were included. A checklist for NVC was developed that included seven nonverbal factors in a mute state (NVM) and four nonverbal factors in speech (NVS), and one point was assigned to each factor. The scores for history taking, PPI, NVM, and NVS were compared, and correlations of each score were evaluated.
RESULTS
Students with adequate facial expressions, accorded speech rate and voice volume, adequately matched voice tone, and few or no moments of unnecessary silence showed better PPI scores. The PPI score was correlated with history taking and the NVS score, but not the NVM score.
CONCLUSION
Our results suggest that NVS may be more influential to PPI during OSCEs than NVM. Communication teachers should help students to be better prepared to use both NVS and NVM properly.
Topics: Checklist; Communication; Curriculum; Education, Medical, Undergraduate; Educational Measurement; Facial Expression; Female; Humans; Medical History Taking; Nonverbal Communication; Patient Satisfaction; Physical Examination; Physician-Patient Relations; Professional Competence; Speech; Students, Medical; Video Recording; Voice
PubMed: 30180507
DOI: 10.3946/kjme.2018.94 -
Psychonomic Bulletin & Review Apr 2020Researchers examining nonverbal communication of emotions are becoming increasingly interested in differentiations between different positive emotional states like... (Review)
Review
Researchers examining nonverbal communication of emotions are becoming increasingly interested in differentiations between different positive emotional states like interest, relief, and pride. But despite the importance of the voice in communicating emotion in general and positive emotion in particular, there is to date no systematic review of what characterizes vocal expressions of different positive emotions. Furthermore, integration and synthesis of current findings are lacking. In this review, we comprehensively review studies (N = 108) investigating acoustic features relating to specific positive emotions in speech prosody and nonverbal vocalizations. We find that happy voices are generally loud with considerable variability in loudness, have high and variable pitch, and are high in the first two formant frequencies. When specific positive emotions are directly compared with each other, pitch mean, loudness mean, and speech rate differ across positive emotions, with patterns mapping onto clusters of emotions, so-called emotion families. For instance, pitch is higher for epistemological emotions (amusement, interest, relief), moderate for savouring emotions (contentment and pleasure), and lower for a prosocial emotion (admiration). Some, but not all, of the differences in acoustic patterns also map on to differences in arousal levels. We end by pointing to limitations in extant work and making concrete proposals for future research on positive emotions in the voice.
Topics: Emotions; Humans; Nonverbal Communication; Speech; Voice
PubMed: 31898261
DOI: 10.3758/s13423-019-01701-x -
The Journal of Neuroscience : the... Apr 2018Steroids play vital roles in animal physiology across species, and the production of specific steroids is associated with particular internal biological functions. The... (Review)
Review
Steroids play vital roles in animal physiology across species, and the production of specific steroids is associated with particular internal biological functions. The internal functions of steroids are, in most cases, quite clear. However, an important feature of many steroids (their chemical stability) allows these molecules to play secondary, external roles as chemical messengers after their excretion via urine, feces, or other shed substances. The presence of steroids in animal excretions has long been appreciated, but their capacity to serve as chemosignals has not received as much attention. In theory, the blend of steroids excreted by an animal contains a readout of its own biological state. Initial mechanistic evidence for external steroid chemosensation arose from studies of many species of fish. In sea lampreys and ray-finned fishes, bile salts were identified as potent olfactory cues and later found to serve as pheromones. Recently, we and others have discovered that neurons in amphibian and mammalian olfactory systems are also highly sensitive to excreted glucocorticoids, sex steroids, and bile acids, and some of these molecules have been confirmed as mammalian pheromones. Steroid chemosensation in olfactory systems, unlike steroid detection in most tissues, is performed by plasma membrane receptors, but the details remain largely unclear. In this review, we present a broad view of steroid detection by vertebrate olfactory systems, focusing on recent research in fishes, amphibians, and mammals. We review confirmed and hypothesized mechanisms of steroid chemosensation in each group and discuss potential impacts on vertebrate social communication.
Topics: Animal Communication; Animals; Chemoreceptor Cells; Humans; Nonverbal Communication; Pheromones, Human; Social Behavior; Steroids
PubMed: 29519850
DOI: 10.1523/JNEUROSCI.2488-17.2018 -
Current Biology : CB Sep 2013
Topics: Animal Communication; Animals; Behavior, Animal; Cues; Humans; Language; Mating Preference, Animal; Nonverbal Communication
PubMed: 24070440
DOI: 10.1016/j.cub.2013.07.070 -
Clinical Psychology & Psychotherapy Jan 2021The examination of nonverbal synchrony has become a promising line of psychotherapy research. Although several studies have found between-dyad associations between...
The examination of nonverbal synchrony has become a promising line of psychotherapy research. Although several studies have found between-dyad associations between nonverbal synchrony and multidimensional outcomes, the findings remain heterogeneous, and within-dyad effects remain to be investigated. The present study examines within and between effects of nonverbal synchrony on mastery, resource activation, problem actuation, and motivational clarification (Grawe's general mechanisms of change). Four-hundred and twenty-three videotaped sessions of 175 patients were analysed using motion energy analysis (MEA), providing values to quantify nonverbal synchrony in the patient-therapist dyad. Grawe's general mechanisms of change in psychotherapy were rated using the Inventory of Therapeutic Interventions and Skills (ITIS). On average, patient-therapist nonverbal synchrony was greater than chance. Hierarchical linear modelling revealed that nonverbal synchrony was significantly associated with higher mastery and less resource activation on the within-dyad level. Nonverbal synchrony was not associated with problem actuation or motivational clarification, and in general, no associations were found on the between-dyad level. The results demonstrate the importance of disentangling within and between effects of nonverbal synchrony and provide initial evidence that nonverbal synchrony is tied to the specific therapeutic strategies observed in psychotherapy sessions.
Topics: Adolescent; Adult; Aged; Female; Humans; Male; Middle Aged; Nonverbal Communication; Psychotherapy; Therapeutic Alliance; Treatment Outcome; Young Adult
PubMed: 32794374
DOI: 10.1002/cpp.2498